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September 21, 2005

Hospital forgotten during Katrina looks for future

by Sam Savage

By Maggie Fox, Health and Science Correspondent

NEW ORLEANS (Reuters) - Dr. Peter De Blieux struggled for
four days to get desperate and impoverished patients safely out
of flooded Charity Hospital in downtown New Orleans. Now he is
fighting to get them back.

Dr. Ben deBoisblanc watched in frustration as helicopter
after helicopter swept away patients and even able-bodied staff
from the for-profit hospital across the flooded street from
Charity, while two of his own desperately ill patients died
after waiting for hours for help.

Three weeks later Charity Hospital sits empty and dark.
Clean sheets cover the examining tables in the emergency room
and hallways once filled with four days worth of human detritus
are pristine.

Outside, De Blieux consults with Army Special Forces troops
who helped drain the remaining putrid water from the basement
so that bodies that have been sitting in the morgue since
before the storm hit on August 29 can be removed.

Now as New Orleans struggles to recover, they say it is
time to decide what kind of future they and their patients will
have.

The future of the non-profit, aging Charity facility, part
of the state-run Louisiana State University system, symbolizes
the dilemmas that must be addressed.

DEFINING A NATION

"I really believe that this will define us as a nation --
how we respond to this," deBoisblanc said in a telephone
interview from his temporary home in Baton Rouge.

"We are either going to do it right or we are going to do
it wrong. I am not saying hand out a free Lexus to everybody
who has been displaced. We have to be very, very careful that
we don't take these victims and somehow ostracize them because
it's inconvenient for us or makes our lives more difficult."

Charity's plight was one of the most dramatic stories to
come out of the storm that first battered New Orleans and then
drowned it with filthy water.

During the crisis, doctors, nurses and other staff carried
their frailest patients upstairs as water filled the basement
and shorted out the generators, and they pleaded for help that
did not arrive for days.

The storm hit on a Monday, and on Wednesday staff were
still pumping by hand to ventilate patients who could not
breathe on their own.

The flood blew out the generators and backed up sewage, and
the hospital began to stink of trash, sweat and human waste.

"It became obvious that FEMA was not going to come," said
deBoisblanc, who runs the intensive care units in the hospital,
referring to the Federal Emergency Management Agency.

"We were going to have to find our own way out."

By Wednesday afternoon some of the trainee doctors, called
residents, called up the television networks. A private
helicopter operator promised to send aircraft if they could get
the patients to a landing pad.

A canoe and a National Guard truck were waved down and four
of the most desperate patients were ferried across the street
to Tulane University's hospital. One Charity patient got out.
The good Samaritan's helicopters were commandeered -- probably
by accident, said deBoisblanc -- to remove three other
patients.

Black Hawk helicopters with night vision eventually came to
the rescue, and deBoisblanc went with one to a triage area on a
highway cloverleaf intersection.

"What do you see but all these ambulances -- dozens of
ambulances. I asked how long have you all been there, and this
guy said three days."

Stunningly, no one had directed the ambulances to other
locations where they could have been put to use.

EVERY ONE FOR HIMSELF

DeBoisblanc flew back to Charity and brought the remaining
30 or so intensive-care patients from his unit to Tulane
hospital across the street.

Once there, "we waited and waited and waited as helicopter
after helicopter landed and loaded up patients, which in some
cases seems valid," he said. "Other times able-bodied doctors,
nurses and family members went while these patients sat on the
rooftop."

It was not completely cold-blooded, deBoisblanc said. Some
helicopters were not configured to carry patients strapped to
boards, and many people had been standing in a line of hundreds
for hours, waiting to get out. It was dark; it was confusing.

But then a very large cargo helicopter arrived.

"It can hold 30 people," deBoisblanc said. And it did -- 30
people who walked aboard on their own.

"We stood there in disbelief that we had 30 patients there
and there was no sense of priority of these sick patients over
other patients. At the time I was pretty pissed off."

Guards with guns were keeping order, said deBoisblanc, and
no arguments were tolerated.

"It was a product of the lack of command and control
structure," he said. "It became survival of the fittest. There
was no sense of shared resources."

People were struggling to take care of those they felt
personally responsible for, deBoisblanc said.

But two patients died, including a frail old woman whose
husband had sat by her side day and night, fanning her to keep
her cool, and who had been expected to survive. They were
separated at the end.

"She died being hugged by lots of wonderful nurses and
residents who cradled her in their arms and petted her and told
her it was all going to be OK. She did not die alone,"
deBoisblanc said.

Some staff, like deBoisblanc, themselves became refugees
after the last patient left the Friday after the storm. He has
not been back.

De Blieux, who helped oversee the emergency department,
commutes daily from his wife and young children in Baton Rouge
to help clean up the hospital.

The building may be old, but it is filled with
state-of-the-art equipment, including a hyperbaric chamber used
to force oxygen into the tissues of seriously ill patients.

De Blieux and other volunteers have labored for days in the
heat and darkness to clear out trash and human waste from the
upper floors.

Despite their efforts, the hospital may never reopen to
patients. The flood fried the electricity panel and ruined the
sewage system.

Charity's administrators see an opportunity to replace the
1930s facility with something newer and better as New Orleans
rebuilds and perhaps reinvents itself.

"Charity Hospital was an obsolete physical plant. The state
had appropriated some money to pay for a new hospital -- a
state-of-the-art indigent care facility. So it doesn't make
sense to spend a lot of money putting the hospital back
together," said deBoisblanc.

"We don't have patients living in New Orleans. What makes
more sense to me is as we re-populate the city, use a temporary
facility."

There is talk of bringing a hospital ship in, says
deBoisblanc. But, he adds, "First of all we have got to make
sure a new hospital is going to be built."

But it would take four years to build one. Where would the
poor of New Orleans go in the meantime?, De Blieux asked.

"It is the only indigent care facility in the city," he
said.

Like everywhere else in the United States, there are
facilities for people with insurance but very little for those
without -- who include the so-called working poor.

The three big New Orleans hospitals that remained operating
through Katrina's fury and afterwards are run by for-profit
corporations, and anyway they are in the suburbs, accessible
only by car.